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Journal of the American Podiatric Medical Association
Volume 95 Number 4 353-356 2005
Copyright © 2005 American Podiatric Medical Association

Efficacy of Fifth Metatarsal Head Resection for Treatment of Chronic Diabetic Foot Ulceration

David G. Armstrong, DPM, MSc, PhD * {dagger} {ddagger}, Mark A. Rosales, DPM * and Agim Gashi, DPM *

* Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Medical Center, Tucson.
{dagger} Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, Chicago, IL.
{ddagger} Department of Medicine, Manchester Royal Infirmary, Manchester, England.

Corresponding author: David G. Armstrong, DPM, MSc, PhD, Department of Surgery, Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd, North Chicago, IL 60064.

Abstract

This study compares the potential benefit of fifth metatarsal head resection versus standard conservative treatment of plantar ulcerations in people with diabetes mellitus. Using a retrospective cohort model, we abstracted data from 40 patients (22 cases and 18 controls) treated for uninfected, nonischemic diabetic foot wounds beneath the fifth metatarsal head. There were no significant differences in sex, age, duration of diabetes mellitus, or degree of glucose control between cases and controls. Patients who underwent a fifth metatarsal head resection healed significantly faster (mean ± SD, 5.8 ± 2.9 versus 8.7 ± 4.3 weeks). Patients were much less likely to reulcerate during the period of evaluation in the surgical group (4.5% versus 27.8%). The results of this study suggest that fifth metatarsal head resection is a potentially effective treatment in patients at high risk of ulceration and reulceration. (J Am Podiatr Med Assoc 95(4): 353–356, 2005)






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Copyright © 2005 by the American Podiatric Medical Association.